Differentiation between active and chronic Crohn%26apos;s disease using MRI small-bowel motility examinations - Initial experience

作者：Bickelhaupt S; Froehlich J M; Cattin R; Patuto N; Tutuian R; Wentz K U; Culmann J L; Raible S; Bouquet H; Bill U; Patak M A^*

来源：Clinical Radiology, 2013, 68(12): 1247-1253.

DOI：10.1016/j.crad.2013.06.024

AIM: To evaluate the influence of locally active Crohn%26apos;s disease on systemic small-bowel motility in patients with chronic Crohn%26apos;s disease compared to healthy individuals. %26lt;br%26gt;MATERIAL AND METHODS: Fifteen healthy individuals (11 men, four women; mean age 37 years) and 20 patients with histopathologically proven active (n = 15; 10 women, 5 men; mean age 45 years) or chronic (n = 5; four women, one man; mean age 48 years) Crohn%26apos;s disease were included in this institutional review board-approved, retrospective study. Magnetic resonance imaging (MRI; 1.5 T) was performed after standardized preparation. Two-dimensional (2D) cine sequences for motility acquisition were performed in apnoea (27 s). Motility assessment was performed using dedicated software in three randomly chosen areas of the small-bowel outside known Crohn%26apos;s disease-affected hotspots. The main quantitative characteristics (frequency, amplitude, occlusion rate) were compared using Student%26apos;s t-test and one-way analysis of variance (ANOVA). %26lt;br%26gt;RESULTS: Three randomly chosen segments were analysed in each participant. Patients with active Crohn%26apos;s disease had significantly (p %26lt; 0.05) reduced contraction frequencies (active Crohn%26apos;s disease: 2.86/min; chronic: 4.14/min; healthy: 4.53/min) and luminal occlusion rates (active: 0.43; chronic: 0.70; healthy: 0.73) compared to healthy individuals and patients with chronic Crohn%26apos;s disease. Contraction amplitudes were significantly reduced during active Crohn%26apos;s disease (6.71 mm) compared to healthy participants (10.14 mm), but this only reached borderline significance in comparison to chronic Crohn%26apos;s disease (8.87 mm). Mean bowel lumen diameter was significantly (p = 0.04) higher in patients with active Crohn%26apos;s disease (16.91 mm) compared to healthy participants (14.79 mm) but not in comparison to patients with chronic Crohn%26apos;s disease (13.68). %26lt;br%26gt;CONCLUSION: The findings of the present study suggest that local inflammatory activity of small-bowel segments in patients with active Crohn%26apos;s disease alters small-bowel motility in distant, non-affected segments. The motility patterns revealed reduced contraction-wave frequencies, amplitudes, and decreased luminal occlusion rates. Thus evaluation of these characteristics potentially helps to differentiate between chronic and active Crohn%26apos;s disease.

• 出版日期2013-12